Critical care is practised by addressing the demands of who should be the recipients of such care and under what circumstances. Even for standard management options, critical care clinicians implicitly identify all available alternatives and possible outcomes, weigh the benefits against the risks and costs, and, in the broadest context, factor in logistic, economic, societal, and legal considerations. Because the critical care unit is a hospital resource with a high level of activity, expenditure, and risk exposure, the benefits of applying evidence-based medicine to the questions 'What should we be doing?' and 'To whom should we be doing it?' are likely to be proportionately great. For the purposes of both maximizing quality improvement and rising to the challenge of most effectively using the available resources for patient care, clinicians and investigators need a common platform upon which they can agree to assemble the facts. Evidence-based clinical guidelines and practice standards are an ideal platform, as they provide the tools required to evaluate and use the medical literature in day-to-day practice.

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